Provider Demographics
NPI:1447283502
Name:HOME REHAB SOLUTIONS OF MICHIGAN LLC
Entity type:Organization
Organization Name:HOME REHAB SOLUTIONS OF MICHIGAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JONATHAN
Authorized Official - Last Name:INDA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:321-277-1983
Mailing Address - Street 1:PO BOX 27517
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48909-0517
Mailing Address - Country:US
Mailing Address - Phone:517-281-7090
Mailing Address - Fax:
Practice Address - Street 1:2407 HOUGHTON HOLLOW DR
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-8417
Practice Address - Country:US
Practice Address - Phone:517-281-7090
Practice Address - Fax:517-694-0260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012670225100000X
MI5201005173225X00000X
MI5201004547225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P31010Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER
MI0P31000Medicare ID - Type UnspecifiedGROUP PROVIDER NUMBER